New Prostate Cancer Treatment May Reduce Side-effects

A new technique to treat early prostate cancer may have far fewer side-effects than existing therapies, say experts.

A 41-patient study in the journal Lancet Oncology suggests targeted ultrasound treatment could reduce the risk of impotence and incontinence.

Researchers say it could transform future treatment if the findings are repeated in larger studies.

New Prostate Cancer Treatment May Reduce Side-effects

The Medical Research Council (MRC), which funded the study, welcomed the results, which it said were promising.

Each year 37,000 men in the UK are diagnosed with prostate cancer. Many face a difficult dilemma: the disease kills about 10,000 men every year, but for some it may not get worse if left untreated.

Standard treatment with surgery or radiotherapy involves treating the whole prostate gland, and can harm surrounding tissue, with a serious risk of side-effects, including urinary incontinence and impotence.

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Targeted Treatment

Doctors at University College Hospital in London have carried out the first trial using high-intensity focused ultrasound (HIFU) aimed at small patches of cancer cells on the prostate.

This was a “proof of concept” study involving 41 patients.

They used a probe, placed close to the prostate, which emits sound waves that heat the targeted cells to 80C, while causing minimal damage to surrounding nerves and muscles.

Hashim Ahmed, a urological surgeon at the trust who led the study, says the results, 12 months after treatment, are very encouraging.

“We’ve shown in this study that focal therapy – by targeting the individual areas of cancer – can avoid the collateral damage. We’ve shown that nine in 10 men had no impotence and none of the men in the study had incontinence of urine.”

Mr Ahmed says the early evidence on cancer control is also very good. But he says this needs to be evaluated in much larger studies.

“This could offer a transformation of the way we treat prostate cancer. It could offer a cost-effective treatment for the NHS, and offer men with early prostate cancer an opportunity to treat their disease, but with very few side-effects.”

A patient on the trial, 72-year-old Robert Page, from Croydon, says his treatment, two years ago, was a great success.

“The outcome was very good,” he said. “I was very pleased with the treatment and very happy with the lack of side-effects, particularly when I contrast that with what might have been the case if I’d had one of the other, alternative, treatments.”

The study was funded by the Medical Research Council, the Pelican Cancer Foundation and St Peter’s Trust.

Further Trials

Professor Gillies McKenna, director of the Gray Institute for Radiation Oncology and Biology, a joint collaboration between the MRC and Cancer Research UK, welcomed the findings.

“If these promising results can be confirmed in a randomised controlled trial, focal therapy could soon become a reasonable treatment choice for prostate cancer alongside other proven effective therapies.”

The chief executive of the Prostate Cancer Charity, Owen Sharp, also emphasised the importance of further research.

“We welcome the development of any prostate-cancer treatment which limits the possibility of damaging side-effects, such as incontinence and impotence. These early results certainly indicate that focal HIFU has the potential to achieve this in the future. However, we need to remember that this treatment was given to fewer than 50 men, without follow-up over a sustained period of time. We look forward to the results of further trials, which we hope will provide a clearer idea of whether this treatment can control cancer in the long term whilst ridding men of the fear that treating their cancer might mean losing their quality of life.”

Are you receiving prostate cancer treatment? What do you think about the new technique? Please send us your comments and experiences. Please note, the BBC cannot pass contact details to the research group.

Source: BBC News UK

                                                    

Huntington’s disease Lowers Cancer Risk

People with Huntington’s disease, a debilitating brain condition, appear have a “protection” from cancer, according to a study in Sweden.

Nearly 40 years of medical records showed patients with Huntington’s had half the normal expected risk of developing tumours.

Researchers, writing in The Lancet Oncology, said the reason was unclear. Cancer Research UK said the findings presented another avenue to explore in tackling cancer.

Academics at Lund University analysed Swedish hospital data from 1969 to 2008. They found 1,510 patients with Huntington’s disease.

Huntington’s disease Lowers Cancer Risk

During the study period, 91 of those patients subsequently developed cancer. The authors said that was 53% lower than the levels expected for the general population.

Huntington’s is one of a group of illnesses called “polyglutamine diseases”. Data from other polyglutamine diseases also showed lower levels of cancer.

The authors said: “We found that the incidence of cancer was significantly lower among patients with polyglutamine diseases than in the general population.

“The mechanisms behind the protective effects against cancer are unclear and further research is warranted.”

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Dr Jianguang Ji, from the Center for Primary Health Care Research at Lund University, told the BBC: “Clarification of the mechanism underlying the link between polyglutamine diseases and cancer in the future could lead to the development of new treatment options for cancer.”

Eleanor Barrie, senior science information officer at Cancer Research UK, said: “These are interesting results. It’s not clear how the genetic changes that cause Huntington’s and other similar diseases could protect against cancer, and research in the lab will help to find out more.

“Scientists at Cancer Research UK and around the world are probing the genetic faults that contribute to cancer in their quest to beat the disease, and this is another potential avenue to explore.”

Source: BBC News UK

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Women’s Height Linked to Ovarian Cancer

Taller women have a slightly higher risk of ovarian cancer, according to a review of studies.

Obesity is also a risk factor among women who have never taken HRT, say international researchers.

Previous studies have suggested a link, but there has been conflicting evidence.

Women’s Height Linked to Ovarian Cancer

The latest research, published in the journal PLoS Medicine, analysed all worldwide data on the topic.

It looked at 47 epidemiological studies in 14 countries, including about 25,000 women with ovarian cancer and more than 80,000 women without ovarian cancer.

Lead researcher Prof Valerie Beral of the Oxford University Epidemiology Unit told the BBC: “By bringing together the worldwide evidence, it became clear that height is a risk factor.”

She said there was also a clear relationship between obesity and ovarian cancer in women who had never taken HRT.

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“Ovarian cancer can clearly be added to the list [of cancers linked to obesity],” she added.

Sarah Williams, health information officer at Cancer Research UK, said the study produced a clearer picture of the factors that could affect a woman’s risk of developing ovarian cancer, and found that body size was important.

“Women can reduce their risk of this and many other diseases by keeping to a healthy weight,” she said.  For women trying to lose weight, the best method is to eat healthily, eat smaller amounts and be more physically active.”

Commenting on the study, Dr Paul Pharoah, reader in cancer epidemiology at the University of Cambridge, said the increase in risk was small.

“If we compare a woman who is 5ft tall with a woman who is 5ft 6in tall, there is a relative difference in ovarian cancer risk of 23%. But the absolute risk difference is small. The shorter woman will have a lifetime risk of about 16-in-a-1000 which increases to 20-in-a-1000 for the taller woman. A similar difference in absolute risk would be seen when comparing a slim woman with a body mass index of 20 to a slightly overweight woman with a body mass index of 30. ”

Source: BBC News UK

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Call for Hairdressers to get Skin Cancer Training

Hairdressers can and should be trained to check their clients for skin cancer, say health experts.

Currently there is no general screening programme in the UK, despite this cancer being one of the most common types.

It is estimated that about 100,000 new cases of skin cancer are diagnosed in the UK every year. But many cases go undetected for years, meaning delayed treatment and a poorer outlook.

Call for Hairdressers to get Skin Cancer Training

The most harmful type of skin cancer, called malignant melanoma, kills more than 2,500 people in the UK every year.

Most cases are preventable – skin cancer is caused by too much exposure to UV light from the sun or sunbeds – but the rates have been increasing over recent years.

People at greatest risk are those with fair, freckled skin and lots of moles. Signs to be aware of include changes to moles, such as itching, bleeding or changing shape or colour.

In women, the cancers occur most commonly on the legs. For men, it is the back. But up to a fifth affect the skin of the head and neck. Lesions on the scalp and the back of the neck can easily go unnoticed, and experts say hairdressers are the ideal people to spot these.

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Untapped Resource

Writing in the latest edition of the Journal of the American Academy of Dermatology, US doctors say: “We should not wait for our patients with skin cancer to come to us when it may be too late, but use research and outreach methods to improve early detection of head and neck melanomas by capitalising on the role of hairdressers and their unique relationship with our potential clients.”

Hairdressers would not be expected to make the diagnosis, but instead to point out any lumps, bumps or sores they find to their client who can bring it to the attention of their own doctor.

Anecdotal research suggests such training is achievable, and work carried out by Nottingham City Hospital NHS Trust found of those hairdressers polled most were keen to do take on the extra responsibility.

Campaigners say the checks could become routine, alongside a cut and blow dry, in the UK’s 36,000 hair salons.

In 2010, the Melanoma Taskforce, a panel of UK skin cancer experts chaired by Sian James MP, produced a set of guidelines for hairdressers and beauty therapists to help them identify malignant melanoma and two other common, less aggressive forms of skin cancer – basal cell carcinoma and squamous cell carcinoma.

Sarah Williams, of Cancer Research UK, a charity that is part of the taskforce, said the campaign now needed evaluating to see whether it has had the desired effect.

She added: “Spotting skin cancer early makes treatment more likely to be successful. So it’s important to raise awareness of the changes to look out for and encourage people to visit their GP if they notice anything unusual. Signs of skin cancer everyone can look out for include changes to the size, shape or colour of a mole, any other change to a mole or patch of skin, or a sore that hasn’t healed after several weeks. If you notice any of these changes, it’s best to get them checked out by a doctor without delay.”

Source: BBC News UK

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Red Meat Increases Death, Cancer and Heart Risk

A diet high in red meat can shorten life expectancy, according to researchers at Harvard Medical School.

The study of more than 120,000 people suggested red meat increased the risk of death from cancer and heart problems. Substituting red meat with fish, chicken or nuts lowered the risks, the authors said.

Red Meat Increases Death, Cancer and Heart Risk

The British Heart Foundation said red meat could still be eaten as part of a balanced diet. The researchers analysed data from 37,698 men between 1986 and 2008 and 83,644 women between 1980 and 2008.

They said adding an extra portion of unprocessed red meat to someone’s daily diet would increase the risk of death by 13%, of fatal cardiovascular disease by 18% and of cancer mortality by 10%. The figures for processed meat were higher, 20% for overall mortality, 21% for death from heart problems and 16% for cancer mortality.

The study said: “We found that a higher intake of red meat was associated with a significantly elevated risk of total, cardiovascular disease, and cancer mortality.

“This association was observed for unprocessed and processed red meat with a relatively greater risk for processed red meat.”

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The researchers suggested that saturated fat from red meat may be behind the increased heart risk and the sodium used in processed meats may “increase cardiovascular disease risk through its effect on blood pressure”.

Victoria Taylor, a dietitian at the British Heart Foundation, said: “Red meat can still be eaten as part of a balanced diet, but go for the leaner cuts and use healthier cooking methods such as grilling.

“If you eat processed meats like bacon, ham, sausages or burgers several times a week, add variation to your diet by substituting these for other protein sources such as fish, poultry, beans or lentils.”

Source: BBC News UK

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Smear Tests Boost Cure Chances

Women diagnosed with cervical cancer as a result of a smear test have a far better chance of being cured than women who do not go for tests, a Swedish study suggests.

The researchers found a 92% cure rate after a smear test diagnosis, compared with 66% for symptoms-based diagnoses.

The study in BMJ looked at all women diagnosed with cervical cancer in Sweden between 1999 and 2001. A cancer charity said screening saved 5,000 UK lives a year.

Smear Tests Boost Cure Chances

The Swedish research, carried out at the Karolinska Institute in Stockholm, followed 1,230 women for an average of eight years after diagnosis.

To estimate the chances of surviving cervical cancer, the study analysed cancers detected by an abnormal smear test result and all other cases based on diagnosis using symptoms.

The percentage of women cured after presenting with symptoms within the recommended interval between screenings was 74%.  But for women with symptoms who were overdue for screening, this cure rate decreased to 60%.

Researchers found that the chances of being cured for all women who had a smear test within the recommended three to five years were 11% higher than for women who were overdue or who had never had a smear test.

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This is a result of screen-detected cancers generally being found at an earlier stage, the study says. Three-quarters of the 373 women who died from cervical cancer in the Swedish study had not had a cervical smear in the recommended timeframe.

Dr Bengt Andrae, study author and senior consultant gynaecologist at Uppsala University, said that screening both reduced the risk of cervical cancer and was linked with improved likelihood of cure. “Even if you have not gone to cervical screening before, go when you are invited because you have a much better prognosis than waiting for the symptoms to appear.”

Recent NHS figures show that one in five UK women decline the offer of a smear test. The Swedish cervical screening programme invites women aged 23-50 to attend every three years and women aged 51-60 to attend every five years.

This is very similar to the UK’s cervical screening programme, although there are variations across the country.

Robert Music, director of Jo’s Cervical Cancer Trust, said the research highlighted the importance of attending cervical screening. “Cervical cancer is largely preventable thanks to cervical screening which saves 5,000 UK lives a year. And for those diagnosed, survival rates are good if the disease is caught early.

But he said he was concerned about the downward trend in screening attendance. “Three pieces of research the charity has undertaken over the past year have identified a number of barriers to attending screening.  There is an urgent need for more investment in targeted campaigns to remind women that they can take proactive steps to reduce their risk of cervical cancer by attending screening. Quite simply it could save their life.”

Source: BBC News UK

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Skin Cancer Drug Hopes Raised by Study

A new treatment for advanced skin cancer almost doubles survival times, according to an international study.

Doctors say 132 patients in the US and Australia who were given the drug vemurafenib gained several extra months of line. Research in the New England Journal of Medicine found those in the study lived an average of 16 months, compared with nine months on conventional treatment.

Vemurafenib (Zelboraf) has been recommended for approval in Europe. The treatment is one of two drugs for late-stage melanoma, approved on fast-track in the US last year, which offer hope for patients with advanced melanoma.

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Before that, there had been no new drugs for the cancer for more than a decade. Vemurafenib is suitable for about half of patients with advanced melanoma as it targets tumours that express a certain gene mutation.

Dr Antoni Ribas, a professor of haematology/oncology and a researcher at the Jonsson Cancer Center at the University of California-Los Angeles, said: “This study shows that Zelboraf changes the natural history of this disease. This data is beyond what I would have expected.

“We’re seeing a significant number of patients with durable responses to the drug, and that the whole group of treated patients is living longer.  These results tell us that this drug is having a very big impact, and this changes the way we treat metastatic melanoma.”

According to the European Medicines Agency, the drug has been recommended for approval in Europe, pending final authorisation by the European Commission.

Elizabeth Woolf, head of Cancer Research UK’s information website Cancer Help UK, said: “This is an interesting, impressive but relatively small trial of a promising new-generation melanoma drug, which Cancer Research UK is proud to have played a role in developing.”

But she said there were still questions that remain unanswered, not least the cost.  “Everyone on the trial had the drug, so we cannot tell how large the benefits are, compared to people who didn’t have it, or had another treatment. And because the drug targets a particular gene fault, only half of all melanoma patients are eligible. About half of those treated seem to benefit, so it could potentially help roughly a quarter of patients with advanced melanoma overall.  Looking at these uncertainties, and now that the drug is available to UK cancer patients, it will be interesting to see what price the manufacturer charges so as not to place too great a strain on already scarce NHS resources.”

Drug resistance

Cancer Research UK said once the drug was licensed in Europe, patients would be able to discuss treatment options with their doctor.

In England, patients will have to apply to the Cancer Drugs Fund, the charity said. Kate Law, director of clinical and population research at Cancer Research UK, said the treatment was one of a new generation of cancer drugs targeted at patients with a specific genetic make-up.

While it offered hope, she said, it was not a cure as the cancer eventually became resistant to the drug.

She told the BBC: “This is not a cure – you’re talking an extra six months of life. We’re getting somewhere with these targeted drugs but we have a whole raft of research still to do to address the issue of resistance.”

Source: BBC News UK

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